Evidence-based treatment of anxiety disorders in Europe - an update

2011 ◽  
Vol 26 (S2) ◽  
pp. 2095-2095
Author(s):  
B. Bandelow
Keyword(s):  
Anxiety Disorders ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Term Treatment ◽  
Treatment Resistant ◽  
Behaviour Therapy ◽  
Short Term Treatment ◽  
Evidence Based Treatment ◽  
Cognitive Behaviour ◽  
History Of ◽  
Channel Modulator

Anxiety disorders are chronic, disabling conditions with prevalence rates higher than the ones of schizophrenia or diabetes.Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are standard treatments for anxiety disorders. The calcium-channel modulator pregabalin is a treatment option for generalized anxiety disorder. Tricyclic antidepressants (TCAs) are as effective as modern antidepressants, but less well tolerated. For short-term treatment and in treatment-resistant cases, benzodiazepines like alprazolam may be used when the patient does not have a history of dependency and tolerance. Combining drug treatment with cognitive behaviour therapy is the most successful treatment strategy in anxiety disorders. Strategies of treatment-resistant anxiety disorders and future anxiolytics will be presented in the symposium.

Efficacy of Cognitive Behaviour Therapy in Generalized Anxiety Disorders

2004 ◽  
Vol 74 (1) ◽  
pp. 36-42 ◽  
Author(s):  
M. Linden ◽  
D. Zubraegel ◽  
T. Baer ◽  
U. Franke ◽  
P. Schlattmann
Keyword(s):  
Anxiety Disorders ◽  
Cognitive Behaviour Therapy ◽  
Generalized Anxiety ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Generalized Anxiety Disorders

Anxiety disorders in older people

2013 ◽  
Author(s):  
Gerard Byrne
Keyword(s):  
Anxiety Disorders ◽  
Older People ◽  
Relaxation Training ◽  
Antidepressant Medication ◽  
Older Person ◽  
Behaviour Therapy ◽  
Pharmacological Interventions ◽  
Cognitive Behaviour ◽  
Other Substances

Anxiety symptoms and anxiety disorders are highly prevalent among older people, including among those with physical frailty and cognitive impairment. Clinicians are advised to consider the effects of prescribed medication and other substances, and the influence of general medical conditions, in the older person presenting with anxiety. Psychological treatments are recommended for older people with anxiety disorders of mild to moderate severity. These include relaxation training, exposure-based interventions, and cognitive behaviour therapy. Pharmacological interventions are in widespread use, although there is little evidence in support of the long-term use of either benzodiazepines or antipsychotics in older people with anxiety disorders. Instead, treatment with antidepressant medication is recommended.

scholarly journals Serotonin tranporter methylation and response to cognitive behaviour therapy in children with anxiety disorders

2014 ◽  
Vol 4 (9) ◽  
pp. e444-e444 ◽  
Author(s):  
S Roberts ◽  
K J Lester ◽  
J L Hudson ◽  
R M Rapee ◽  
C Creswell ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Anxiety Disorders ◽  
Cognitive Behaviour Therapy ◽  
Environmental Influences ◽  
Psychological Therapy ◽  
Behaviour Therapy ◽  
Effective Treatment Option ◽  
Cognitive Behaviour ◽  
Before And After ◽  
Beneficial Response

Abstract Anxiety disorders that are the most commonly occurring psychiatric disorders in childhood, are associated with a range of social and educational impairments and often continue into adulthood. Cognitive behaviour therapy (CBT) is an effective treatment option for the majority of cases, although up to 35–45% of children do not achieve remission. Recent research suggests that some genetic variants may be associated with a more beneficial response to psychological therapy. Epigenetic mechanisms such as DNA methylation work at the interface between genetic and environmental influences. Furthermore, epigenetic alterations at the serotonin transporter (SERT) promoter region have been associated with environmental influences such as stressful life experiences. In this study, we measured DNA methylation upstream of SERT in 116 children with an anxiety disorder, before and after receiving CBT. Change during treatment in percentage DNA methylation was significantly different in treatment responders vs nonresponders. This effect was driven by one CpG site in particular, at which responders increased in methylation, whereas nonresponders showed a decrease in DNA methylation. This is the first study to demonstrate differences in SERT methylation change in association with response to a purely psychological therapy. These findings confirm that biological changes occur alongside changes in symptomatology following a psychological therapy such as CBT.

scholarly journals Stepped Care Cognitive Behavioural Therapy for Children with Anxiety Disorders: A New Treatment Approach

2010 ◽  
Vol 39 (1) ◽  
pp. 55-75 ◽  
Author(s):  
Adelinde J. M. van der Leeden ◽  
Brigit M. van Widenfelt ◽  
Rien van der Leeden ◽  
Juliette M. Liber ◽  
Elisabeth M. W. J. Utens ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Treatment Approach ◽  
Treatment Phase ◽  
Behavioural Therapy ◽  
Additional Treatment ◽  
Stepped Care ◽  
Depression Symptoms ◽  
Behaviour Therapy ◽  
Cognitive Behaviour

Background: The current nonrandomized clinical trial explored changes over time in children with an anxiety disorder during stepped care, manual-based cognitive behaviour therapy (CBT). Methods: Clinically anxious children (8–12 years, n = 133) and their parents participated in child focused CBT (10 sessions). If assessments indicated additional treatment was necessary, participants could step up to a second and possibly third treatment phase (each 5 sessions) including more parental involvement. Results: After the first treatment phase 45% of the Intention-To-Treat sample was free of any anxiety disorder; after the second and third phase an additional 17% and 11% respectively. In total, 74% of the children no longer met criteria for any anxiety disorder following treatment. Child and parent reported anxiety and depression symptoms of children improved significantly during all treatment phases, as well as child reported anxiety sensitivity and negative affect. Children participating in more treatment showed significant improvements during additional treatment phases, indicating that late change occurred for the subgroup that had not changed during the first phase. Conclusions: Stepped care offers a standardized, assessment based, yet tailored treatment approach for children with anxiety disorders. A more intensive treatment is offered when initial CBT is insufficient, providing children additional opportunities to reach the desired outcome.

scholarly journals Cognitive Behavioural Therapy for Japanese Children and Adolescents with Anxiety Disorders: A Pilot Study

2012 ◽  
Vol 40 (3) ◽  
pp. 271-285 ◽  
Author(s):  
Shin-ichi Ishikawa ◽  
Naoyasu Motomura ◽  
Yasuo Kawabata ◽  
Hidetaka Tanaka ◽  
Sakie Shimotsu ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Children And Adolescents ◽  
Behavioural Therapy ◽  
Behaviour Therapy ◽  
Japanese Children ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour ◽  
Self Talk ◽  
Future Challenges

Background: Thirty-three Japanese children and adolescents diagnosed with an anxiety disorder participated in individual or group Cognitive Behaviour Therapy (CBT) that was modelled after evidence-based intervention programs developed in Western countries. Method: The treatment consisted of: (a) building rapport and education; (b) identifying emotions and recognizing cognitive self-talk; (c) challenging anxious self-talk; (d) developing an anxiety hierarchy and in vivo exposures; and (e) planning for future challenges. Results: Three months following treatment, 20 of the 33 children and adolescents (60.91%) no longer met criteria for their principal anxiety disorders and 16 (48.48%) were free from all anxiety disorders. Self-reported anxiety, depression, and cognitive errors also decreased significantly from pre- to post-treatment and these gains were maintained at 3-month follow-up. For the most part, similar outcomes were found in both the group and individual formats of CBT. Conclusions: This study provides preliminary support for the transportability of CBT in both an individual and group format to Japan.

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